How Home Health Providers Are Using Data in End-of-Life Conversations

By Elizabeth Ecker | November 7, 2016

For many home health patients who are chronically ill, there is a natural progression that takes place: home health is provided, eventually a palliative review is conducted after some period of decline, and the patient moves to hospice care where he or she spends on average, 7 to 12 days before passing away.

But what if patients could improve their quality of life, moving into hospice care sooner and spending a longer period of time with their friends and family at the end of their lives?

One technology provider is working with home health providers to this end. By running a complex analysis of OASIS patient data, the technology can gauge which patients are likely to experience decline leading to their end of life.

“Identifying patients earlier is a real value at the end of life when the patient overwhelmingly wants to be at home with family,” said Dan Hogan, president, CEO and founder of Medalogix, during a recent MedCity Engage Conference panel discussion in La Jolla, Calif.

Patients may opt to transition to hospice care from home health based on the recommendation of their health care providers and a doctor’s assessment, but many do not know that the option is available, or the possible benefits they might receive, said David Spencer, regional manager of market development for San Diego-based Mission Healthcare, on the same panel.

“End-of-life discussions are very different from any other type of care,” Spencer said. “Most people say, ‘I wish I had found this sooner,’ [when they learn about the benefits of hospice care].”

For many people, it means living at home, for longer, undergoing fewer medical interventions, and being able to spend time comfortably with friends and family. But for many patients, they are not prompted to have a conversation about what happens next. Instead, they receive all of the medical interventions that are possible, often sparing no expense.

“This prompts us to have the conversation,” Spencer said. “It’s third party objective data.”

Regulations prevent hospice providers and home health providers from having any interaction in California, where Mission Healthcare operates. Taking patients from home health and moving them to hospice care plans can present conflicts of interest that the regulations aim to combat. Hence the need for an independent organization that merely arms the care team with information to generate a dialogue with patients and their families to learn what is possible.

Medalogix essentially assigns a number to each patient in a home health care provider’s caseload, with 1 being at the highest risk for morbidity.

While health care professionals often have a sense of the sickest patients who are likely high on this scale, those who are less obvious are the greatest beneficiaries of the technology, Hogan said.

In many cases, the home health provider can gain insight that would not be available without the analytics.

“Diagnosis isn’t a predictor for mortality,” he said. “Neither is hospital discharge.”